Orthodontic Exposure

Orthodontic exposure is a surgical procedure performed on an impacted tooth, a tooth that has been unable to fully erupt from the gums. Wisdom teeth are the most common teeth to become impacted, but, because they serve no important function, they are typically removed before they can cause any problems. The next most frequently impacted teeth are the canine teeth, also known as eye teeth. This is a more serious situation since canine teeth are very important for biting, ripping and tearing food. When canine teeth become impacted, an effort is made to move them back into their normal position so that they can function properly.

Other teeth may also become impacted and require orthodontic exposure. After the wisdom teeth and canines, the teeth most commonly affected in this way are the second molars, the bicuspids and the lower jaw cuspids.

Reasons for an Impacted Tooth

Teeth become impacted because something interferes with their normal eruption from the gum. Possible causes of impaction are soft tissue that is abnormally dense, blockage by another malpositioned tooth or bone, or cysts in the mouth. Even if a tooth emerges only partially, it is considered to be impacted and must be exposed and repositioned or, in the most difficult cases, extracted.

While impacted wisdom teeth may not be causing symptoms, they are often removed prophylactically since they may decay and result in serious infections at a future date.

The Orthodontic-Exposure Procedure

Usually, more than one dentist is involved in orthodontic exposure. First, the orthodontist fits braces onto the patient's teeth to pull them apart in order to make room for the impacted tooth. Next, the patient is typically referred to an oral and maxillofacial surgeon for an extraction of any teeth that are blocking the impacted tooth. The teeth presenting a blockage to normal eruption may be primary (baby), permanent (adult), or supernumerary (extra) teeth.

Dr. Anderson exposes the impacted tooth by removing the gum tissue and bone covering the impacted tooth. This enables the orthodontist to attach an orthodontic device to help the tooth erupt. The orthodontist will use the attached appliances to gradually, over time, move the exposed tooth into its appropriate location.

The orthodontic treatment designed to coax the formerly impacted tooth into its correct position may take a year or two to complete, but is well worth the effort in terms of dental health and facial aesthetics.

On relatively rare occasions, when it is impossible for the orthodontist to guide the impacted tooth into proper alignment, the unerupted tooth may have to be extracted. If this occurs, treatment options to replace the missing tooth will be discussed. In some situations, if the dentists agree that this is a prudent approach, the impacted tooth will be left in place.

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